DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20192321

Adherence to anti-tuberculosis treatment among patients in urban field practice area of medical college, Davangere, Karnataka: a qualitative study

Geethalakshmi R. G., Madonna J. D'souza, Ashok .

Abstract


Background: Despite effective diagnosis and free treatment, prevalence of TB is still growing. DOTS was introduced by WHO in 1997, which is more than two decades ago. It’s a known fact in TB that adherence is less due to long duration of treatment and stigma associated with it. This study was conducted with the objective of estimating and the reasons for the non- adherence to anti tuberculosis treatment in urban field practice area of SSIMS & RC, Davangere.

Methods: A qualitative method of study design was used. 20 TB patients who are on anti-tuberculosis treatment were interviewed with a structured questionnaire for adherence to treatment. Among them patients who were non adherent were further interviewed in depth to know the reasons for non-adherence.

Results: Data analysis resulted in extraction of five themes, which were side effects, financial burden and social support, duration of treatment, food insecurity, unawareness of consequences of non-adherence to treatment.

Conclusions: Patient adherence to treatment is multi-factorial and involves individual patient factors, provider factors, and community factors. Addressing issue of non-adherence to treatment requires enhanced efforts towards resolving medical problems like adverse drug effects, developing short duration treatment regimens, motivational counselling, social, family support for patients and improving awareness about disease. 


Keywords


Tuberculosis treatment adherence, Side effects, Food insecurity

Full Text:

PDF

References


Styblo K, Bumgarner J. Tuberculosis can be controlled with existing technologies: evidence. The Hague: tuberculosis surveillance research unit. 1991: 60–72.

World Health Organization. TB - A Global Emergence. World Health Organization, Geneva, 1994.

World health statistics. Monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2017.

World Health Organization. TB in South Africa. Geneva: WHO; 2009.

Dick J, Lombard C. Shared vision a health education project designed to enhance adherence to anti tuberculosis treatment. Int J Tuberc Lung Dis. 1997;1:181–6.

Khan J, Irfan M, Zaki A, Beg M, Hussain SF, Rizvi N. Knowledge, attitude and misconceptions regarding tuberculosis in Pakistani patients. J Pak Med Assoc. 2006;56(5):211.

Ali SS, Rabbani F, Siddiqui UN, Zaidi AH, Sophie A, Virani SJ, Younus NA. Tuberculosis: do we know enough? A study of patients and their families in an out-patient hospital setting in Karachi, Pakistan. Int J Tuberc Lung Dis. 2003;7(11):1052–8

Esther S. When TB treatment fails: A socio-behavioral account of patient adherence. Am Rev Respir Dis. 1993;147:1311–20.

Kumareson J. Epidemiology. In: Narayan JP, editor. Tuberculosis: Epidemiology and Control. 1st ed. New Delhi: WHO Regional Office for South-East Asia; 2002: 16–17.

Culqui DR, Munayco E CV, Grijalva CG, Cayla JA, Horna-Campos O, Alva Ch K, et al. Factors associated with the non-completion of conventional anti-tuberculosis treatment in Peru. Arch Bronconeumol. 2012;48:150–5

Johansson E, Long NH, Diwan VK, Winkvist A. Attitudes to compliance with tuberculosis treatment among women and men in Vietnam. Int J Tuberc Lung Dis. 1999;3(10):862–8.

Khan A, Walley J, Newell J, Imdad N. Tuberculosis in Pakistan: socio-cultural constraints and opportunities in treatment. Soc Sci Med. 2000;50(2):247–54.

Gebremariam MK, Bjune GA, Frich JC. Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment: a qualitative study. BMC Public Health. 2010;10(1):651.